Writing The Goodbye: The Hypnotic Use of Systemic Storytelling to Facilitate Forced Termination in a Case of Complex Childhood Trauma

Abstract

The termination of a therapeutic relationship constitutes a clinically significant moment that can either consolidate prior therapeutic gains or, conversely, reactivate core psychological vulnerabilities. This is particularly true in patients with preexisting attachment pathology. Endings of clinical therapy that are imposed externally, driven by institutional constraints rather than clinical readiness, present a specific challenge for which there is limited published guidance, especially in paediatric contexts. This paper presents a clinical case study that illustrates the use of systemic storytelling as a technique for facilitating a forced therapy termination in paediatric psychiatry. The patient, a 13-year-old boy with a history of sexual abuse, severe attachment disorder, placement instability, and multiple early maladaptive schemas, faced an abrupt, institutionally mandated end to a long-standing therapeutic relationship. Drawing on Philippe Caillé's method of the systemic tale and integrating a preparatory state of calm to minimise dissociative risk, the therapist composed a metaphorical narrative encoding the patient's relational history, therapeutic journey, and separation, which was read aloud during the final session in the presence of two significant attachment figures. The intervention appeared to facilitate a meaningful, emotionally contained farewell, which resulted in interrupting the patient's established pattern of crisis-driven relational endings. Follow-up information obtained over two years post-termination indicates sustained clinical improvement, including cessation of crisis hospitalisations and successful integration into vocational and social contexts. The systemic tale offers a flexible tool for navigating therapy termination in complex paediatric cases where conventional ending protocols cannot be used. The case also helps to show the countertransference dimensions of forced endings and the role of clinical supervision as a generative space for creative therapeutic solutions.